Abstract
In the Scandinavian countries Sweden, Denmark, Norway, and Finland, the number of first generation migrants reaching an old age, who will be in need of age-related health-care, is rapidly increasing. This situation poses new demands on health-care facilities, such as memory clinics, where patients with memory problems and other dementia symptoms are referred for examination and evaluation. Very many elderly people with a foreign background require the assistance of an interpreter in their encounter with health-care facilities. The use of, and work by an interpreter is crucial in facilitating a smooth assessment. However, interpreters, clinicians, as well as patients and their companions, may be faced with many challenges during the evaluation procedure. The aim of this case-study is to highlight some of the challenges that occur in relation to a specific activity within the dementia evaluation, namely the test of cognitive functioning. Special attention will be paid to the phenomenon ‘repair’, i.e., participants’ joint attempts to solve upcoming difficulties during the course of interaction. Results show that sources of trouble may be related to the lack of cultural, linguistic, and educational adaptation of the test to the patient, and to interpreter and clinician practises. Findings will be discussed in terms of test-validity, clinician and interpreter training, and the institutional goals and constraints of the dementia evaluation. The methodology Conversation Analysis has been used to conduct a highly detailed analysis of participants’ practices and actions during the administration of the test.
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Notes
The case is part of a larger data-base of video and audio recorded dementia evaluations from two Swedish memory clinics, as part of a research project on ethnicity and dementia carried out at Center for Dementia Research, Linköping University. The project has been approved by the regional board for ethical vetting.
This information was obtained from the interview with the occupational therapist who administered the test, and had worked with the same interpreter and patient at a previous occasion.
There are also differences between the languages in terms of the use of relative pronouns, which, in Kurdish, are optional and often omitted, which might affect translations.
The eventual diagnosis of the patient cannot be revealed here due to patient confidentiality requirements. In the interview with the occupational therapist that was conducted immediately after the assessment, however, she expressed that her impression was that the patient had cognitive difficulties. It should be stressed that this impression was not only related to the just performed test, but also based on the occupational therapist’s previous experiences of the patient.
Kammarkollegiet is the oldest public authority in Sweden. One of its undertakings is to handle authorizations of interpreters and translators (www.kammarkollegiet.se)
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Acknowledgments
The present study was supported by The Bank of Sweden Tercentenary Foundation (RJ), grant no. M10-0187:1.
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Plejert, C., Antelius, E., Yazdanpanah, M. et al. ‘There’s a letter called ef’ on Challenges and Repair in Interpreter-Mediated Tests of Cognitive Functioning in Dementia Evaluations: A Case Study. J Cross Cult Gerontol 30, 163–187 (2015). https://doi.org/10.1007/s10823-015-9262-0
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DOI: https://doi.org/10.1007/s10823-015-9262-0